Why do people not like Medicare Advantage?

Asked by: Lesley Hauck  |  Last update: January 19, 2026
Score: 4.5/5 (69 votes)

Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.

Why do people say not to get a Medicare Advantage plan?

Many people choose MA plans for their extra benefits and out-of-pocket limits. But MA plans have some potential disadvantages. They have smaller provider networks and often require prior authorization. And with an MA plan, you won't have access to Medigap supplement insurance to cover your out-of-pocket costs.

What is the biggest disadvantage of Medicare Advantage?

The biggest disadvantage of Medicare Advantage is that you have fewer doctors to choose from when you get medical care.
  • Plans can also cost more overall than Original Medicare if you have complex medical needs. ...
  • With some plans, you don't have any coverage if you use a doctor that isn't in the network.

Why are people leaving Medicare Advantage?

Medicare Advantage plans often have a limited network of hospitals and physicians. And while the premiums are typically low, enrollees could end up paying more in the long run in copays and deductibles if they develop a serious illness.

Why don't doctors like Medicare Advantage?

Administrative Burden: Medicare Advantage plans can have complex administrative requirements, including prior authorizations and extensive paperwork. This can increase the workload for physicians and their staff, making participation less appealing.

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Why are hospitals refusing Medicare Advantage plans?

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.

Why do people choose original Medicare over Medicare Advantage?

There's no one-size-fits-all answer, but Medicare Advantage typically has lower premiums and optional coverage, while Original Medicare often gives you more choice when it comes to choosing doctors.

Why are seniors losing Medicare Advantage plans?

Health systems and hospitals are also making the decision to cancel contracts due to excessive prior authorization denial rates and slow payments from insurers. Already 27 health systems have canceled their Medicare Advantage contracts this year.

Can I drop my medicare advantage plan and go back to original Medicare?

Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.

Why is a medicare supplement better than an advantage plan?

The biggest difference between Medicare Supplement Insurance, also known as Medigap, and Medicare Advantage is that with a Medigap plan, you have the freedom to see any doctor that accepts Medicare. With Medicare Advantage, you generally must get care within the plan's network of providers.

Do all hospitals accept Medicare Advantage plans?

While most hospitals do accept Original Medicare, there may be some that do not accept Medicare Advantage Plans. However, if you have a medical emergency while you're enrolled in a Medicare Advantage plan, you can seek care at any ER or hospital in the country.

What is the best Medicare plan that covers everything for seniors?

Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.

Does everyone have to pay $170 a month for Medicare?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

Are most people happy with Medicare Advantage?

Beneficiaries in Traditional Medicare and Medicare Advantage plans say they're largely happy, but have plenty of issues with each program. When Americans are asked what they think about Medicare, they generally rate the program highly.

What is the alternative to Medicare Advantage plans?

A Medigap policy is a supplement to Original Medicare coverage. When you're getting started with Medicare, you can either buy Medigap or enroll in a Medicare Advantage Plan, but you can't have both. You can't buy Medigap while you're in a Medicare Advantage Plan unless you're switching back to Original Medicare.

Is Humana pulling out of Medicare Advantage plans?

Humana will stop offering Medicare Advantage (MA) in 13 counties in 2025, Humana CFO Susan Diamond said in a published report in Becker's Payer Issues dated Sept. 3, 2024.

What is the downside of a Medicare Advantage Plan?

Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.

What is the two midnight rule for Medicare Advantage?

The two-midnight presumption directs medical reviewers to select Original Fee-for-Service Medicare Part A claims for review under a presumption that hospital stays that span two midnights after an inpatient admission are reasonable and necessary Part A payment.

Why are hospitals not taking Medicare Advantage plans?

Excessive prior authorization denial rates, slow payments from health insurers among the reasons. Medicare Advantage (MA) provides health coverage to more than half of the nation's older adults, but some hospitals and health systems are opting to end their contracts with MA plans over administrative challenges.

Why are people leaving Medicare Advantage plans during?

Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.

What percent of seniors choose Medicare Advantage?

In 2024, 32.8 million people are enrolled in a Medicare Advantage plan, accounting for more than half, or 54 percent, of the eligible Medicare population, and $462 billion (or 54%) of total federal Medicare spending (net of offsetting receipts, such as premiums).

What is the best Medicare insurance for seniors?

The Best Medicare Advantage Companies of 2025 include:
  • Best Medicare Advantage Company: Aetna Medicare, Blue Cross Blue Shield of Michigan Mutual Ins. Co., Devoted Health, Inc., Highmark Health.
  • Best Medicare Part D Company: Centene Corporation, Elevance Health, Inc., Humana Inc., Medica Holding Company.

What is the disadvantage of UnitedHealthcare for seniors?

Cons About UnitedHealthcare Medicare Advantage

You may only have access to certain HMO or PPO plans in your area. And while UnitedHealthCare has competitive pricing, your location may only have access to plans with higher deductibles, more copays, and fewer additional benefits.

What are the 6 things Medicare doesn't cover?

Some of the items and services Medicare doesn't cover include:
  • Eye exams (for prescription eyeglasses)
  • Long-term care.
  • Cosmetic surgery.
  • Massage therapy.
  • Routine physical exams.
  • Hearing aids and exams for fitting them.